Management of iatrogenic spinal stenosis complicating placement of a fusion cage : A case report

A case of iatrogenic spinal stenosis secondary to fusion cage retropulsion is presented. To highlight fusion cage retropulsion, a potential complication that may become more prevalent as the use of fusion cage instrumentation expands. The difficulty in management of this complication is emphasized. Early reports regarding fusion cage instrumentation have been encouraging. At this point, however, the potential benefits are better defined than the potential complications. A significant complication of fusion cage instrumentation and the limited literature on this subject are reviewed. The patient underwent successful revision surgery after retropulsion of a fusion cage, however, an extensive surgical procedure including partial vertebral body resection was required. The frequency and severity of complications related to fusion cage instrumentation remain poorly defined. Caution should be used in patient selection until additional experience more clearly defines the risk-to-benefit ratio for a given application of this new technology.